Lifetime Adversity Research Articles

Traumatic events in childhood and adulthood in a diverse-ancestry sample and their role in bipolar disorder

We examined the presence of adverse events in both childhood and adulthood and the prevalence of PTSD in individuals with Bipolar Disorder (BD). There were 191 adults diagnosed with BD Type I and 924 controls, of predominantly African Ancestry (AA). All were administered the GPC-Screening Tool and the BD group the DIPAD. In addition Childhood adversities were measured using the ACE (from 0 to 10), about traumatic events before age 18 and lifetime adversities were measured with 15 questions adapted from the Study of Addiction: Genetics and Environment (A-SAGE (from 0 to 15) for all cases and controls. Probable PTSD (pPTSD) was measured with 4 questions on the GPC screener. Sum scores were calculated for the ACE and A-SAGE by tallying positive responses. Odd Ratios (OR) were used to measure the association between BD and Controls exposure to adversity. BD was associated with a significantly higher mean ACE score and A-SAGE score compared to controls. There was a significantly higher prevalence of pPTSD in the BD (54.5%) versus Controls (6.6%) as well. Greater OR's were seen in the BD compared to Controls for each ACE question (p<0.05). Results were similar for A-SAGE. Limitations include possible recall bias, and missing data.

Exploring strengths, psychological functioning and youth victimization among American Indians and Alaska Natives in four southern states

BackgroundIdentifying factors that support healthy psychological functioning after experiencing violence or other adversities in youth can lead to better prevention and intervention efforts. This is particularly important among communities with disproportionately high rates of adversity resulting from legacies of social and political injustices, such as American Indian and Alaska Native populations. MethodsData were pooled from four studies in the southern U.S. to examine a subsample of American Indian/Alaska Native participants (N = 147; mean age 28.54 years, SD = 16.3). Using the resilience portfolio model, we investigate the impact of three categories of psychosocial strengths (regulatory, meaning making, and interpersonal) on psychological functioning (subjective well-being and trauma symptoms), controlling for youth victimization, lifetime adversities, age, and gender. ResultsIn examining subjective well-being, the full model accounted for 52 % of the variance, with strengths explaining more variance than adversities (45 % vs 6 %). For trauma symptoms, the full model accounted for 28 % of the variance, with strengths and adversities accounting nearly equally for the variance (14 % and 13 %). DiscussionPsychological endurance and sense of purpose showed the most promise for bolstering subjective well-being while poly-strengths (having a diversity of multiple strengths) was most predictive of fewer trauma symptoms. Building psychosocial strengths offers promising strategies for prevention and intervention in Native nations and communities.

Life-course adversity and sleep disturbance among low-income women with children

ObjectivesThis study explored whether patterns of lifetime adversity are associated with sleep disturbance and tested whether adult adversity mediates the relationship between childhood adversity and sleep. MethodsA sample of 1510 postpartum women in Wisconsin who received home visiting services completed assessments of childhood adversity, adult adversity, and sleep disturbance; 989 women completed another sleep assessment about one year later. Latent class analysis was used to identify classes of lifetime adversity, which were then used to predict later sleep ratings while controlling for earlier sleep ratings and demographic variables. A path analysis was conducted to explore whether adult adversity mediated the association between childhood adversity and sleep. ResultsAdverse childhood and adult experiences were highly prevalent, and greater life-course adversity was associated with sleep disturbance. The association between childhood adversity and sleep was significantly mediated by adult adversity. ConclusionsSleep quality appears to correspond with life-course adversity, pointing to ongoing opportunities for prevention and intervention.

A qualitative investigation into the cultural master narrative for overcoming trauma and adversity in the United Kingdom.

esearch in the field of narrative psychology has found that redemption—a narrative sequence in which people recount emotionally negative experiences as having positive endings—is a useful mechanism for coping with adversity. Redemption has been viewed as a cultural master narrative in North America, providing individuals with a socially valued script for narrating challenging life experiences. Presently little research has examined the presence and function of the redemption narrative outside of North American contexts. The aim of this qualitative study, therefore, was to identify themes in U.K. individuals’ narratives of trauma and adversity to gain insight into the content of the master narrative for meaning-making in the U.K. Sixty-five participants (57 females, Mage = 21.97, SD = 7.24) with little to no experience of lifetime adversity were recruited into an online survey. Participants answered open-ended questions adopting the perspective of a survivor from a selected U.K. national tragedy, focusing on how they felt survivors could recover from trauma. We identified 2 themes in our thematic analysis that were relevant to recovery: recuperation and redemption. Recuperation was most commonly reported, it was described as a gradual lessening of symptoms over time and the ability to cope with the lasting emotional and physical scars. Our findings suggest that redemption is not necessarily the dominant cultural script in the U.K. for guiding recovery in the aftermath of trauma. (APA PsycInfo Database Record (c) 2020 APA, all rights reserved)

Growth differences by school-age and adolescence according to in utero and peripartum antiretroviral therapy exposure among Ugandan children.

In utero/peripartum antiretroviral (IPA) drug exposure in human immunodeficiency virus (HIV)-exposed children has established benefit for prevention of HIV mother-to-child-transmission but its association with height-for-age by adolescence is unknown. Hence we quantify IPA-associated growth differences at 6 to 18 years old among children with perinatally acquired HIV (CPHIV) infection and children HIV exposed but uninfected (CHEU) relative to children HIV unexposed and uninfected (CHUU). Cohort study. Kampala, Uganda. Two hundred thirty eight community controls and 490 children of women living with HIV born between 2000 and 2011 in a community were enrolled at 6 to 18 years of age and followed every 6 months for 1 year. Height-for-age determined at enrollment, 6 and 12 months after enrollment using the World Health Organization reference. IPA exposure was retrospectively determined from medical records and categorized as: no IPA, single-dose nevirapine with/without zidovudine (sdNVP ± AZT), sdNVP + AZT + lamivudine, or combination antiretroviral therapy (cART). Mean differences (β) with 95% confidence intervals (CIs) in height-for-age over 12 months were evaluated according to IPA exposure for CPHIV and CHEU and relative to CHUU using longitudinal linear mixed effects models adjusted for caregiver factors (sex, age, education, functioning in caregiving role, and lifetime adversity) in Statistical Analysis Software (v.9.4). Regardless of IPA type, CPHIV grew worse than CHUU by school-age/adolescence (β = -0.30, 95% CI: -0.48, -0.11). Relative to CHUU height-for-age was similar for CHEU exposed to sdNVP ± AZT (β = -0.16, 95% CI: -0.46, 0.14) and for CHEU exposed to sdNVP + AZT + lamivudine (β = 0.08, 95% CI: -0.20, 0.35). However, CHEU without any IPA exposure had lower height-for-age (β = -0.27, 95% CI: -0.52, -0.00) whereas CHEU with cART exposure had greater height-for-age (β = 0.41, 95% CI: 0.10, 0.71) in comparison with CHUU by 6 to 18 years old. Our findings suggest that CHEU may achieve height-for-age parity with CHUU by school-age and adolescent years- especially if provided benefit of effective cART in the peripartum period. However, CPHIV regardless of IPA exposure type and CHEU without IPA exposure remain at a disadvantage and will benefit from intervention to support their growth.

Neuroticism and adverse life events are important determinants in functional somatic disorders: the DanFunD study

Several psychological factors have been proposed to be associated with functional somatic disorders (FSD). However, large population-based studies investigating the importance of both personality and adverse life events (ALE) are sparse. This study aimed to investigate the association between FSD and neuroticism and the accumulated number of ALE, respectively. This cross-sectional study included a random sample of the adult Danish population (N = 7493). FSD were established by means of self-reported questionnaires and diagnostic interviews. Neuroticism was measured with the Danish version of the short-form NEO Personality Inventory. ALE were measured with the Danish version of the Cumulative Lifetime Adversity Measure. Strong positive associations were found between neuroticism and FSD, and ALE and questionnaire-based FSD. For interview-based FSD, strong positive associations were found for FSD, multi-organ type, and for the subtype of the general symptoms. The level of self-efficacy did not modify these associations, and no moderating effect of neuroticism and ALE in combination on the probability of having FSD was found. FSD were strongly associated with both neuroticism and the accumulated number of ALE, and these associations were not modified by self-efficacy. In combination, neuroticism and ALE did not have a moderating effect on the probability of having FSD.

Adversity effects on nonword repetition skills: A proxy measure of language and reading ability

BackgroundChildren exposed to adversity are at increased risk for underachievement in reading; however, how early that risk appears and the mechanisms underlying that risk are unclear. ObjectiveIdentify whether individual variation in nonword repetition—a clinical indicator of language and reading ability—can be captured in early childhood (three- to five-years-old) and how various features of adversity exposure (e.g., dosage, severity) are associated with performance. Participants and settingCommunity-based sample of children between the ages of three- and five-years-old who were exposed to significant adversity (n = 92) and living in a major Midwestern metropolitan area. MethodsParticipants completed a nonword repetition task, and their parent completed a comprehensive adversity questionnaire to report on the child's cumulative lifetime adversity exposure. ResultsOver a third of the participants (34.78 %) did not meet age expectations on the nonword repetition task; however, nonword repetition performance did not significantly associate with the features of the adverse experience (i.e., dosage, severity, frequency, chronicity). ConclusionsRisk for underachievement in reading appears early in the preschool years for children exposed to adversity; however, the underlying mechanisms remain unclear since the features of the children's adverse experiences did not associate with their performance. Implications for prevention and early identification within the learning context are discussed.

Lifetime Adversity in the Context of Monthly Adversity and Psychological Well-Being in Midlife: Evidence of Cumulative Disadvantage, But Not Steeling Effects of Lifetime Adversity.

Our objective is to examine whether lifetime adversity has either a "steeling effect" or "cumulative disadvantage effect" on the consequences of monthly adversity on psychological well-being in middle-aged adults. An exploratory step was to examine whether such associations differed based on the domain of adversity (personal, family/friend, bereavement, social-environmental, and relationship). Multilevel modeling was applied to data from a sample of participants in midlife (n = 358, ages 50-65, 54% women) who were assessed monthly for 2 years. Lifetime adversity did not show steeling effects, but instead appeared to exacerbate the impact of monthly adversity on psychological well-being, indicating cumulative disadvantage. On months where an adversity was reported, on average, individuals who reported more lifetime adversity showed stronger increases in depressive symptoms, anxiety, and negative affect and decreases in positive affect. There was limited evidence to suggest for steeling effects for life satisfaction. Reporting adversity in the personal, bereavement, social-environmental, and relationship domains showed the strongest associations with psychological well-being. Our discussion focuses on how lifetime adversity showed a cumulative disadvantage effect on the consequences of monthly adversity on psychological well-being. We also elaborate on future directions for research that include other conceptualizations of adversity and research to examine mechanisms underlying this relationship.

Classes of lifetime adversities among emerging adult women by race/ethnicity and their associations with weight status in the United States

This cross-sectional study examines the association of childhood and adolescent/adult adversities with obesity across four racial/ethnic groups among emerging adult women aged 18 to 25 (n = 9310). Latent class analysis was used to identify racial/ethnicity-specific classes arising from childhood and adolescent/adult adversity indicators in the 2015 and 2018 College Student Health Surveys (sampled from Minnesota, U.S.) Distal outcome procedure and Bolck-Croon-Hagenaars methods were used to assess each class's association with body mass index (BMI) and obesity probability. Models were adjusted for post-secondary school type and parental education. We identified 7 classes for White women, 4 classes for Asian and Latina women, and 5 classes for Black women. Weight distributions of Black and Latina women leaned towards “overweight”, whereas White and Asian women's BMI leaned towards “normal weight.” Latina and Black women had a wider BMI range (~5 kg/m2) between classes with the highest versus lowest BMI than White and Asian women (~3 kg/m2), suggesting a stronger association between adversities and BMI. For Asian, Black, and White women, the “Low Adversities” class had the lowest obesity prevalence, while the “High Lifetime Adversities” class had the highest prevalence. In contrast, Latina women had the lowest obesity prevalence in the “High Adolescent/Adult Adversities & Low Childhood Adversities” class, and highest prevalence in the “Household Mental Illness” class. Results indicate that racial/ethnic disparities in obesity-related measures are reduced when racial/ethnic groups experience low adversity. Future research should explore tailored adversity interventions that consider adversity exposure differences across race/ethnicity as a strategy for reducing obesity risk.

Lifetime adversity interacts with peritraumatic data-driven processing to predict intrusive memories

Background and objectivesAlthough most trauma survivors experience some intrusive recollections of the traumatic event, only few subsequently develop posttraumatic stress disorder (PTSD). A well-established proximal risk-factor predictive of post-trauma psychopathology is peritraumatic cognitive processing. Another, more distal risk-factor is pre-trauma lifetime adversity. The present experimental analogue study tested the hypothesis that pre-trauma lifetime adversity interacts with peritraumatic perceptual (i.e., data-driven) processing to predict intrusive memory development. MethodsFifty-three young adult women (non-clinical sample) indicated how much data-driven and conceptual processing they had engaged in while watching aversive film-clips (i.e., analogue trauma). On the subsequent three days, they reported intrusions of those clips. Moderation analyses tested for an interaction effect between lifetime adversity and data-driven processing in predicting intrusion load (number of intrusions weighted for their overall distress). ResultsIncreased data-driven processing predicted intrusion load primarily in individuals reporting more than three lifetime adversities, explaining 55% of variance. No such relationship was found for conceptual processing. LimitationsPresent analogue findings have yet to be replicated in a clinical population. Moreover, the conceptual processing scale was restricted by low internal consistency. ConclusionPresent findings support the idea that intrusions are the result of poorly elaborated and primarily perceptually-formed memory traces; however, this was primarily the case in vulnerable individuals reporting several lifetime adversities. Results replicate the importance of peritraumatic processing in intrusion development but additionally point to a moderating effect of lifetime adversity.

Puerto Ricans and Mexican immigrants differ in their psychological responses to patterns of lifetime adversity.

Puerto Ricans and Mexican immigrants are often exposed to multiple types of adversity across their lifetime (e.g., maltreatment, household dysfunction, discrimination) and this exposure can increase the risk for adult mental health problems. The objective of this study was to (a) identify subgroups of individuals exposed to unique combinations of childhood adversity and lifetime discrimination among Puerto Ricans and Mexican immigrants, and (b) compare the prevalence of mental health problems across different risk profiles. We used existing data from the HCHS/SOL Sociocultural Ancillary Study. Participants included Puerto Rican (N = 402) and Mexican adults (N = 1351) born outside but living in the continental U.S. Through latent profile analysis, we selected a three-profile solution for Puerto Ricans: (a) Low Exposure (low on all adversity items; 58% of sample), (b) Adverse Childhood Experiences (ACEs) Only (high on ACEs items, average or lower than average on discrimination items; 32%), and (c) Dual Exposure (high on all adversity items; 10%). For Mexicans, we selected a four-profile solution: (a) Low Exposure (52%), (b) ACEs Only (24%), (c) Maltreatment and Discrimination (15%), and (d) Dual Exposure (9%). For Mexicans, we found that the Dual Exposure and the Maltreatment and Discrimination profiles had the highest levels of mental health problems. For Puerto Ricans, the Dual Exposure and ACEs Only profiles had the highest levels of mental health problems, suggesting that Puerto Ricans may be more vulnerable to the effects of childhood adversities as compared to Mexican immigrants. Results from our study indicate that different patterns of adversity exposure are linked to different levels of mental health outcomes, and therefore, may require different intervention dosage. Understanding which groups of individuals are at highest and lowest risk for mental health problems is critical for developing effective, tailored interventions to prevent the negative effects of childhood adversity and discrimination for Latinxs.

Is psychosis a syndemic manifestation of historical and contemporary adversity? Findings from UK Biobank.

Psychosis is associated with many forms of adversity, deprivation and living in urban areas. To investigate whether psychosis is part of a syndemic of multiple adversities. Drawing on UK Biobank (UKBB) data (Project ID: 57601), we sought to understand mechanisms by which childhood, recent/contemporary and place-based adversities might cluster and interact to be implicated in pathways by which psychoses evolve. We investigated the associations between adversities, potential mediating inflammatory markers and ICD-10 diagnoses (F20-F31) of psychotic disorders. We fitted logistic regression models initially including all relevant candidate variables and used backwards deletion to retain theoretically plausible and statistically significant (P < 0.05) associations with psychotic disorders. The candidate variables were entered in a partial least squares structural equation model (PLS-SEM) to test for syndemic interactions between risk factors. We tested whether the findings were sensitive to demographics, gender and ethnicity. We fitted a PLS-SEM including psychosis as a syndemic outcome, and identified three latent constructs: lifetime adversity, current adversity and biomarkers. Factor loadings were above 0.30, and all structural paths were significant (P < 0.05). There were moderate associations between lifetime adversity and current adversity (standardised coefficient s.c. = 0.178) and between current adversity and biomarkers (s.c. = 0.227). All three latent constructs showed small but significant associations with psychosis (s.c. < 0.04). Lifetime adversity and current adversity were more strongly associated among ethnic minorities (combined) than White British people. Our findings stress the importance of interactions between childhood and contemporary adversities in preventive and therapeutic interventions for psychotic disorders, especially among ethnic minorities.

Prevalence of and Relationship Between Caregiver Adversity Scores and Child Client Eco-systemic Structural Family Therapy (ESFT) Outcome: Implications for Family Based Mental Health Services (FBMHS).

Adverse childhood experiences, especially with primary caregivers, impacts the mental, physical, and relational health of individuals (Felitti et al. in Am J Prev Med, 14(4):245–258. 10.1016/s0749-3797(98)00017-8, 1998). Therefore, caregiver adversity is important to consider when delivering therapeutic interventions to children (Gardner et al. in Clin Soc Work J 42(1):81–89. 10.1007/s10615-012-0428-8, 2014; Eslinger et al. in J Child Fam Stud 24(9):2757. 10.1007/s10826-014-0079-1, 2015; Hagan et al. in J Trauma Stress 30(6):690–697, 2017). This study analyzed archival data to understand the role of caregiver adversity in Eco-Systemic Structural Family Therapy (ESFT) outcomes, within Family Based Mental Health Services. Results indicate caregiver lifetime adversity score did not predict treatment outcome. However, caregiver current adversity and family length of stay were negatively correlated as were length of stay and client discharge level of care. These findings suggest that ESFT benefits families regardless of caregiver childhood adversity level and that clinician attention to caregiver current adversity is important to ensure families receive the full benefits of ESFT. Implications for optimizing ESFT and future directions for ESFT clinical research are discussed.

Adversity in early life and pregnancy are immunologically distinct from total life adversity: macrophage-associated phenotypes in women exposed to interpersonal violence

Early childhood and pregnancy are two sensitive periods of heightened immune plasticity, when exposure to adversity may disproportionately increase health risks. However, we need deeper phenotyping to disentangle the impact of adversity during sensitive periods from that across the total lifespan. This study examined whether retrospective reports of adversity during childhood or pregnancy were associated with inflammatory imbalance, in an ethnically diverse cohort of 53 low-income women seeking family-based trauma treatment following exposure to interpersonal violence. Structured interviews assessed early life adversity (trauma exposure ≤ age 5), pregnancy adversity, and total lifetime adversity. Blood serum was assayed for pro-inflammatory (TNF-a, IL-1ß, IL-6, and CRP) and anti-inflammatory (IL-1RA, IL-4, and IL-10) cytokines. CD14+ monocytes were isolated in a subsample (n = 42) and gene expression assayed by RNA sequencing (Illumina HiSeq 4000; TruSeq cDNA library). The primary outcome was a macrophage-associated M1/M2 gene expression phenotype. To evaluate sensitivity and specificity, we contrasted M1/M2 gene expression with a second, clinically-validated macrophage-associated immunosuppressive phenotype (endotoxin tolerance) and with pro-inflammatory and anti-inflammatory cytokine levels. Adjusting for demographics, socioeconomic status, and psychopathology, higher adversity in early life (ß = .337, p = 0.029) and pregnancy (ß = .332, p = 0.032) were each associated with higher M1/M2 gene expression, whereas higher lifetime adversity (ß = −.341, p = 0.031) was associated with lower immunosuppressive gene expression. Adversity during sensitive periods was uniquely associated with M1/M2 imbalance, among low-income women with interpersonal violence exposure. Given that M1/M2 imbalance is found in sepsis, severe COVID-19 and myriad chronic diseases, these findings implicate novel immune mechanisms underlying the impact of adversity on health.

Does Gender Role Conflict Moderate the Relationship Between Lifetime Adversity and HIV Stigma in a Community Sample of HIV-Seropositive Black Men?

Previous research highlights the need to better understand the complex relationships between factors marginalizing Black men who have sex with men and women (MSMW) living with HIV, including HIV stigma, trauma, and hegemonic masculinity. We examined associations between gender role conflict (GRC), trauma, and HIV stigma in Black MSMW living with HIV. 117 participants completed the UCLA Life Adversities Screener (LADS), measures of GRC, and HIV stigma. A multivariate model with age, gender role, and the LADS as predictors of stigma was statistically significant F (4, 110) = 12.81, p &lt; .0001. The LADS was significantly associated with stigma ( b = 11.06, t = 4.17, p &lt; .0001) and moderated by GRC ( b = 12.19, t = 2.25, p &lt; .05); stigma increased significantly at high, but not low GRC. High GRC heightens the relationship between trauma and HIV stigma in Black MSMW. Future research must investigate associations among trauma burden, stigma, and GRC among vulnerable populations.

Living well with mental illness: Findings from India

ABSTRACT In India, mental illness is generally perceived as a lifetime adversity with high vulnerability to problems such as social marginalization, health hazards, and economic deprivation. But anecdotal evidence has shown that many individuals struggling with mental illness have led outstanding lives of courage, dignity and have contributed to society in different ways. Yet scientific research has not focused adequately on such cases and instead has largely studied negative outcomes associated with mental illness. The objective of the present study was to explore positive outcomes through the subjective experiences of individuals diagnosed with mental illness. Interviews of participants (n = 48) were analyzed using thematic analysis. The imperative finding was that despite mental illness and cumulative risks, participants were able to bounce back to a functional level and in a few instances even excelled in specific areas they engaged in. The major implication of such strength-based studies is that it highlights positive outcomes that can assist in building a life of wellness thereby challenging the deficit-based approach that is more popularly followed in studying mental illness. These findings establish that the possibility of living well even after being diagnosed with a mental illness is not a fictional likelihood, rather an achievable reality.

Classes of lifetime adversity in emerging adult women and men and their associations with weight status

The aim of this paper was to better understand how child and adult adversities cluster together into classes, and how these classes relate to body weight and obesity. Analyses included 2015 and 2018 data from emerging adults (18–25 years old) who participated in a state surveillance system of 2- and 4-year college students in Minnesota (N = 7475 in 2015 and N = 6683 in 2018). Latent Class Analyses (LCA) of 12 child and adult adversities were run stratified by gender and replicated between 2015 and 2018. The distal outcome procedure and three-step Bolck-Croon-Hagenaars approach were used to estimate predicted BMI means and predicted probabilities of obesity for each class, adjusted for covariates. The LCA identified seven classes in women and 5 in men. In women, BMI ranged from 23.9 kg/m2 in the lowest-BMI class (“Adult Adversities and Childhood Household Dysfunction”; 95% CI: 22.6–25.1) to 27.3 kg/m2 in the highest-BMI class (“High Lifetime Adversities”; 95% CI: 25.9–28.7), a statistically significant difference of 3.4 kg/m2. In men, the adjusted BMIs ranged from 24.6 kg/m2 (“Low Adversities”; 95% CI: 24.3–25.0) to 26.0 kg/m2 (“Childhood Household Mental Illness”; 95% CI: 25.1–26.9), a statistically significant difference of 1.4 kg/m2. The pattern was similar for obesity. These results indicate that specific classes of child and adult adversities are strongly associated with BMI and obesity, particularly in women. A key contribution of LCA appeared to be identification of small classes at high risk for excess weight.

Factors That Promote Vulnerability Versus Resilience Among Older Disaster Survivors

Catastrophic environmental events, such as floods and hurricanes, are associated with widespread destruction and loss of life. Older adults, who often have health challenges and medical co-morbidities, appear to be at greater risk for adverse post-disaster outcomes, such as depression, worry, and medical uncertainty, than younger adults impacted by the same disaster. Researchers, therefore, are interested in identifying factors that tend to bring about vulnerability and adverse outcomes for older adults during and after a disaster, as well as factors that may generate resilience and psychological well-being for older adults. The purpose of this symposium is to present research based on multiple disaster experiences and to examine factors associated with vulnerability and resilience. The first two speakers introduce empirical findings from research that addresses flooding, the 2016 Baton Rouge flooding and the frequent flooding of coastal Louisiana brought about by coastal erosion. The next two presenters explore successful VA and Non-VA Home-Based programs during and after the 2017 Hurricane Maria in Puerto Rico and during the 2017 Atlantic hurricane season. The final speaker highlights the impact of lifetime trauma on the recovery of older adults following a natural disaster. Collectively, these presenters will provide evidence of how lifetime adversity is a factor promoting vulnerability for older adults after a disaster. Critically, they will also examine how age, disaster preparedness, intense patient tracking, VA support networks, and community resources and programs are protective factors generating resilience post-disaster for older adult populations.

Trauma and Adversity: Factors Impacting Vulnerability and Resilience Among Older Disaster Survivors

Most would agree that older adults represent a highly vulnerable group prior to, during and post disaster. Age-related vulnerabilities often lead into an increased risk for traumatic experiences and post-traumatic stress symptoms after a disaster. Trauma informed principles offer a possible way to reduce the vulnerability of older adults after a disaster. For example, utilizing the trauma informed question “what has happened to you” shifts the focus from a deficit approach and allows for a deeper understanding of the impact of traumatic life experiences on current functioning and reaction to the disaster. It is this understanding of trauma’s impact that may have a role in how older adult disaster survivors view, respond, and recover after a natural disaster (Seery et.al. 2010; Iacoviello & Charney, 2014). In addition, understanding the role of lifetime adversity provides critical insights for disaster planning, reducing vulnerability and promoting resilience among older disaster survivors.

Lifetime stressful experiences and cognitive performance in African American and white older adults: New evidence from a population‐based cohort

AbstractBackgroundGrowing evidence suggests that modifiable sociocontextual factors powerfully shape health including risk for Alzheimer's disease and related dementias (ADRD), and contribute substantially to well‐established racial disparities in cognitive aging. Stressful experiences cluster and accumulate across the lifespan, plausibly impacting brain health, but cognitive effects of lifetime adversity across diverse populations remain underexplored. We examined relationships between lifetime stressful events and cognition among African American and White older adults in the Health and Retirement Study (HRS).MethodThe study sample included non‐demented adults (N=8,222) aged 60 and older who provided cognitive and lifetime stress data at the 2006/08 and 2010/12 HRS waves. Cognitive outcomes included performance on a test of global cognition (Telephone Interview for Cognitive Status) and its immediate and delayed recall subscales. The key predictor of interest was a Lifetime Stress index score (sample range=0‐11 experiences). Mixed‐effects regression models assessed associations of lifetime stress with each cognitive outcome. Polynomial and three‐way interaction models explored potential (1) non‐linear associations between stress and cognition, and (2) moderation of those relationships by race.ResultAfrican Americans (N=1,015) were younger (M=71.7, SD=6.8) than whites (M=72.2, SD=6.3) and reported fewer years of education (p&lt;0.001). Reported number of stressful life events reported (M=1.61, SD=1.45) did not vary by race. In adjusted models (Table 1, Model 2), a significant stress quadratic revealed that relationships with global cognition (p&lt;0.001) and delayed recall (p=0.01) were non‐linear. Modification by African American race (Table 1, Model 3; Figure 1) was observed for global cognition (p=0.01) but not recall subscales (immediate: p=0.10; delayed: p=0.45).ConclusionWe found that lifetime stress is associated with poorer later‐life cognitive function; however, detriment is observed only at high levels of stress. African American and White HRS participants report very few stressful life events on average, but African Americans reporting many stressors showed exacerbated stressor‐associated dysfunction in global cognition. Our findings from this large, population‐based sample reaffirm the role for stress and stress‐adjacent experiences in cognitive aging, particularly among communities facing disproportionate ADRD burden. Expanding community‐specific, lifecourse‐based research and intervention strategies is a necessary next step toward understanding and mitigating disparity through targeted resource placement and stakeholder partnerships.